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When It Isn’t Just Clutter Anymore

By Paula Span January 20, 2010 11:27 amJanuary 20, 2010 11:27 am

She was a retired college professor, living alone in a New York apartment that had become unmanageable. When she called Bergfeld’s Estate Clearance Service for help, Kristin Bergfeld had trouble entering the apartment; the professor had to move objects out of the way simply to open her front door.

Julie WetherellThe living room, above, and bedroom, below, of a hoarder.

Inside, Ms. Bergfeld found a familiar scene: a person overwhelmed by her possessions, many of them unused or useless. “You know those big plaid plastic bags people use for laundry?” she recalled. “About 100 of those, filled with teaching materials from the last 10 years. Clothing items she’d bought from catalogs, 10 of each in different colors with the price tags still on them. Lots and lots of bottles for recycling — maybe 30 large trash bags — that never made it out.”

The stuff was stacked three feet deep. In the bedroom, it reached the ceiling. The professor could no longer use her bed; she slept in a cleared space on her kitchen floor. “It’s a heart-breaker every time I see it,” Ms. Bergfeld said. “This is an intelligent, engaging person who was hugely embarrassed and ashamed.”

Hoarding — a compulsive need to acquire and inability to discard items of no apparent value, to the point where one’s ability to function becomes impaired — is a disorder that begins early in life, researchers are learning. But the symptoms appear to increase with each decade of age and so, of course, does the sheer amount of stuff amassed.

What do elders hoard? Junk mail. Plastic containers. “Newspapers are very common,” said Julie Wetherell, a psychiatry professor at the University of California, San Diego, who has written about the phenomenon. “Plastic bags from the grocery store. Some people hoard food. Or animals — the people with a hundred cats. If something is on sale at the dollar store, instead of buying three or four boxes, hoarders buy 40.”

Suggest that you clear away the clutter, as adult children often do, and a hoarder will come up with a litany of reasons to refuse: He is going to get around to reading those papers one day. The mess doesn’t bother him, so why should it bother you? It’s his home, so back off. “Hoarders are very resistant to an offer to help,” Dr. Wetherell said. “And very resentful if you try to do anything behind their backs.”

Besides, a one-time cleanup operation is only a temporary fix for this syndrome. “It’s a chronic condition,” said Catherine Ayers, Dr. Wetherell’s co-author and colleague at the university. “If you clean out the home, the person will reclutter it within six months.”

A parent’s inability to part with a collection of plastic bags or a three-year pile of catalogs, though sometimes exasperating, may not pose a serious problem. But taken to extremes, clutter can cause fires, draw rodents and roaches, and increase the risk of falling as elderly people navigate around piles of debris. “It’s a continuum,” Dr. Eric Lenze, a Washington University geriatric psychiatrist, said of hoarding. “If it’s unsafe — a fire hazard or a sanitation hazard — then it’s clearly crossed the line.”

The professor’s pattern was not uncommon; therapists who work with such patients tell about whole sections of residences becoming unusable as they silt over with stuff, leading to poor nutrition when people can no longer prepare meals or poor hygiene when they can no longer bathe. But it is such a hidden problem, invisible outside the home, that only family members may see it.

Though it strikes me as an odd form of entertainment, executives at the cable channel A&E have found the subject compelling enough to produce a show called “Hoarders” in which people struggle to gain control over their lives. I can see the potential drama, though: without help, hoarders can face social isolation, eviction, even lawsuits or action by adult protective service agencies if they’re found to be endangering their own well-being.

So it would be nice to report that there is a simple, reliable, widely available treatment. Not yet, sadly. Researchers are still unraveling this conundrum, uncertain how to classify the disorder. Though often associated with obsessive-compulsive disorder — and the Obsessive Compulsive Foundation Web site has useful information on hoarding — it appears to be a separate syndrome.

“It’s a problem we don’t have a name for or much understanding of,” Dr. Wetherell said. “And yet we all see it.” But a variant of cognitive behavioral therapy, in combination with the drugs called serotonin reuptake inhibitors, shows promise in helping people begin the painful process of discarding.

It has taken Ms. Bergfeld’s crew eight full days over several months to liberate the professor, who is also seeing a counselor and will need follow-up sessions with a professional organizer. But the encroaching rubbish is much reduced; the professor can sleep in her bedroom now.

“Once she could let somebody in and say, ‘I have a problem, can you help?,’ there was huge relief,” Ms. Bergfeld said. “I told her, ‘You’ve done the most important thing.’”

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

A year and a half ago, an old family friend died. A university professor in her mid-seventies, she was a lovely woman and a compulsive hoarder.

It took months for her sons and me to clear out her two-bedroom flat — and then there were the storage spaces. From those, we moved 4.1 tons of stuff. (The weight was measured at the junk yard.)

The oldest newspaper in storage was worth finding: The announcement of the start of WWI.

The oldest newspaper in the apartment was from 1967. My friend had (deeply buried) shopping bags of newspapers. Indeed, she had stretched her sheets over newspapers. She had paperwork from a business that closed in the 1980s. Takeaway containers, broken window fans, cat-shredded clothing . . .

She had asthma, and there can be little doubt that her living conditions contributed to her death.

You’d never have known it, meeting her — polished, beautifully attired, elegant, intelligent — in the street or at work, but she lived in nearly ceiling-high chaos, as she had done since her early thirties. She mourned the fact that she did not have a home into which she could welcome her children, grandchildren and friends.

Like those who cared for her, she hoped she would not do so until her death. She hoped and she hoarded, and she did so to the end.

I have read that hoarding often has a strong genetic component, and also that it may be a type of anxiety disorder: those who hoard feel protected, well stocked for any circumstance, “armored,” or are trying to fill an emotional gap.

I wonder whether there has been a recent upsurge in the disorder or whether it is just now being recognized as something other than “eccentricity.”

One sentence in this story bothers me everytime that I see it used somewhere, ““This is an intelligent, engaging person who was hugely embarrassed and ashamed.”
“Intelligence” is not an indicator of ehtics, morals, or common sense, it never has been, it never will be. “Intelligent” people deserve no more sympathy or pity than us “regular uneducated folk” do.

I have decided this is not a malady that can be fixed in my 90 year old mother. It’s just another one of her body’s processes that is going haywire–decision making. Just as she takes an inordinate amount of time to pick out a pair of shoes (and then moments later is sure she is wrong), she could not make the simple decision to throw out an empty yogurt container when her closets contained 50.

Although there are evidently extreme situations as mentioned in this article, there are also less severe problems that families have to resolve. A chronically messy home that can still be navigated can still cause anguish. My mother-in-law’s apartment required a month of week-ends with 6 of us working to clean it out after she was moved into assisted living – protesting loudly the whole time. Only then could the trash be removed. And even then there was a lot of just old stuff with no value that was stored. At one time one brother’s wife would not allow her children to stay overnight in the apartment because she tought it was a fire trap. And this situation does not come close to what is described above or in the television program.

It must be a genetic tendency because both of my sisters-in-law have messy homes, espcially one of them. My husband also has trouble turning loose of old useless things that are 30-40 years old. I have to really work hard to give away things, old clothes, boxes of unfinished projects, etc.

My mother doesn’t have a problem with hoarding so much as she has a problem with throwing old things away. There will be a garage sale “someday” (news flash: all the sellable stuff was garage-saled years ago and only junk remains), or she’s “going to sell it on eBay” or my favorite, “I just have to go through this stuff” (she’s had 15 years since her mother died yet won’t accept any offers of help because that would mean calling in a junk hauler). Thank God she’s not a spendthrift – no, it’s just old junk she wants to hang on to forever, no new stuff coming in.

Hoarders can be a public menace if their home catches fire. An extremely dilapidated house caught fire in my neighborhood. Online reports said that the firemen were having trouble fighting the fire because of the ‘mass of material inside the home.’ Luckily, it was not very windy, the fire was put out, and the fire did not spread to adjacent homes. That the residents were hoarders is now apparent to all who drive by the shell of a house with piles and piles of charred stuff left inside.

The house was so dilapidated, I often wondered why the city had not condemned it. Next time, I will be proactive and call the city and demand someone check out the situation.

My grandmother was a hoarder of plastic bins, junk mail, newspapers, pens, canned food. 30 years plus of newspapers piled everywhere in her house. One day, she finally let my mother throw away some piles of papers. What made her change her mind, I will never quite know. We started clearing out the newspapers 3 months prior to her first event as a book group hostess.

The urge runs in the family, but my mother and I combat it by regularly going through our possessions and donating. It helps that I have been moving every year or so. Forced weeding.

I do believe that it gets worse as you get older, so unfortunately minimalism will never become my style!

Thanks for the blog post. So other than clean out the space for an elder parent who hoards (only to have it refilled in weeks) what can you do? Any resources or suggestions? My parent lives in a house that we have cleaned out on several occasions, but she only continues her hoarding. Our family has confronted her several times on this, she refuses or cannot see that this is a problem that is now affecting her physical health. How can I help her? I welcome any suggestions.

Maybe there are different types of hoarding, or different reasons for it, but I don’t suspect that in all instances it is ‘chronic’, or that once all the stuff is cleared out, that the person will necessarily automatically revert back.

I would imagine there are a good number of hoarders who, once they began the actual hoarding, it never ceased. The piles in their apartment just grew. Perhaps they even found additional space to spread their stuff out. At some point, it obviously becomes overwhelming. Where to even begin?! Then they feel guilty, depressed, incapable of any action…. Which is understandable if you are that deep in muck so to speak.

However, I would imagine that for some hoarders, that once all that stuff IS removed, that, after an adjustment period and perhaps extreme feelings of vulnerability (I’m sure all that ‘stuff’ provides some physical comfort…sort of like a coccoon….), and not knowing what to ‘do’ with their time (because they are no longer hoarding, sorting through piles etc….)…that eventually it must be very liberating. And I would imagine that the idea of going back to how they used to be would be so terrifitying, that they’d make a concerted effort to maybe even go the other way….and constantly be purging their possessions?

Ellen and Kitty, your mothers sound like mine. When she finally had to go into an assisted living complex, her house was a nightmare of epic proportions. We had to have an estate sale, allow several charities to come over & take what they wanted, and then trash the rest before a realtor could even start showing the house. The sad thing is to the charities & people at the estate sale, the contents of my mother’s home (a product of her mother’s hoarding, her sister’s hoarding, and her own hoarding) were just so much stuff. The items she felt were so precious to her own life and memory were just a dollar’s worth of junk to the people who bought it. This was a horrible experience – she felt alone and sad at the loss of “her life” as she called it, and I felt angry and guilty for having to be the one responsible for taking it from her.

I’ve often wondered what the people who hoard are trying to do – subconsiously. Is it that they feel powerless, seek control in their lives and, since they can’t get it, they control what they can – things they collect? While watching the “Hoarders” show the people seem, for the most part, to be fairly intelligent. It must be a feeling of being out of control emotionally. However, as the stuff they have accumulates to the point where they can’t move around easily in their homes – where things become inaccessible that they need to live – don’t they lose actual control of themselves, of their lives? How bizzare human’s are! How strange it is that we can get lost in a reality of our own creation – one that has little relation to what is healthy and normal in the world. I don’t judge these people. We’ve all done things that confused us later – we couldn’t understand how we could think or do those things. Or we’ve ended up in places we never expected through the happenstance of circumstance. All of us need light in our darkness, a helping and understanding hand when we fall. All of us need guidance, understanding and knowledge that translates into wisdom. I pray we all find that hand that makes the path clear – clears out the debri in our lives – and sets us free. The ‘mind’ is a spiritual concept – something that pervades but also transcends our physical being. Hoarders are struggling with emotional/mental/spiritual difficulties. Why not let the One who is spiritual – God – guide us in what is reasonable, good and right?!

good stuff, no real solutions. hoarding is tricky because, yes, a true hoarder will get upset if anyone tries to help or clean.

amy of “ask amy” recently said, “hoarding isn’t common.” BS! everyone i know has 1 relative who hoards, all to the point where their homes are impossible to enter. I have a hoarder aunt and I hope to god this behavior isn’t inherited by any of us.

That A&E show is very interesting; I hope they do more episodes. The animal hoarding – the animal waste, the fact that there are more than just the hoarder’s own life that’s affected – really disturbs me. I’ve worked with a number of elderly people who ‘enable’ feral cat colonies, and they have – to a man and woman – been emotionally disturbed. They fight you every step of the way, even if you bring the animals back after being spayed/neutered. They feed the animals secretly after you’ve set traps. They disable traps. They can be rude and combative. One lady told me she cried after running over and killing the second kitten (!) of the seven in the litter, but saw nothing wrong with having 19 cats and kittens running loose on her small property. It took me almost a year to get all her cats spayed/neutered, and I took the kittens away & got them into good homes. This lady now has four cats, but I’m constantly going over and taking more off her property – lord knows where she gets ’em!
If you know an elderly person who has a number of cats, please try to get them some help, because they are about to be overwhelmed. Cats can breed early (under a year) and often (females can be impregnated by multiple males). You may not want to call the official animal control people right off the bat, but do call a volunteer animal rescue organization and see what they can do. Here in Sarasota there are a dozen girls I could call right now who would be happy to help, and I’m confident every community would have a similar response. Animal control should be your last option, but calling them is a whole lot better than doing nothing.

Sometimes my mother and I would throw out my father’s 40 year old college textbooks, say, to thrift shop collection boxes. He’d go and retrieve them.

I had a long lost relative who turned up at 90 y.o. after being mugged. She was an animal hoarder, a cat lady. Both have served as warnings to me. I definitely have the tendency. Especially as an artist/writer–everything has some potential future usefulness–but it’s the little stuff–the loose screws that fell off of something you can’t quite recall where they came from, the buttons that need to go back onto some item of clothing, the extra buttons that come with a garment, the little rubber feet that come in the box with the toaster, the toaster-over and camera manuals, and the voxes they come in–these are the things that drive me crazy.

Sometimes it is not hoarding, exactly, but a dementia symptom in which the elder just cannot quite remember HOW to take out the trash, nor how to sort-out things that should be kept fro the other stuff.

akira said: (I’m sure all that ’stuff’ provides some physical comfort…sort of like a coccoon….)

I think that’s part of it, too. We lived next door to a hoarder for 20+ years. She never once let us set foot in her house, although she came into ours often. When her children forced her to move out, the amount of stuff in that place was unbelievable!! She was very neat in her storage methods, however, stacking newspapers into lidded storage tubs (but cleverly covering the top layer with fabric–to outwit her husband!).

She had spent thousands of dollars on clothing and food–purchased but never worn/eaten. She continued to buy enough food each week for a large family (she raised 6 children), even though she lived alone.

Her family worked for months and barely made a dent in the cleanup. The house is now deserted but still 2/3 full. For a while, she would make “midnight runs” to fill the trunk of her car with whatever she could manage and take it to her new residence, which, I’ve been told, is also full to the rafters.

We’ve never understood it, and sadly, her family has given up on her, because she gets so angry with them for acting like she’s got “something wrong” with her.

It’s so very sad. I wish scientists could figure out the trigger for it and work on ways to help these people get out of the hoarding trap…

I think hording is a physiological malady associated with feelings of inadequacy and low self image. When I feel that way I sometimes but stuff that I really don’t need and then store it in closets so it’s out of the way. What I’ve found that works for me is to purge one area of my home periodically and donate as much as possible to charity and then toss out the rest. It works because I feel I am being helpful by giving to someone who has a real need.

Julianne Moore gives a wonderful performance in “Still Alice,” but the film skirts the truth about dementia.Read more…

About

Thanks to the marvels of medical science, our parents are living longer than ever before. Most will spend years dependent on others for the most basic needs. That burden falls to their baby boomer children. The New Old Age blog explored this unprecedented intergenerational challenge. Paula Span will continue to write New Old Age columns twice monthly at nytimes.com/health and the conversation will continue on Twitter (@paula_span) and Facebook.